Dr. Benjamin Olowojebutu, the chairman of the Nigerian Medical Association’s Lagos State Chapter, discusses the demands of the association and the events surrounding the death of a medical officer, Dr. Vwaere Diaso, at the General Hospital in Odan, Lagos, on August 1, 2023.
How has the atmosphere changed since Dr. Vwaere Diaso’s passing?
It’s been incredibly sober. With extremely poor working conditions and poor workplace safety, we have been forced to live in pain and make sober reflections about our lives as doctors. The doctors in Lagos are suffering, and we are lamenting the loss of our deceased colleague. For us, it is a very painful situation. We pray that murder of this gruesome nature never occurs in our neighbourhood again.
Could you describe the sequence of events that led to her passing?
She was injured on her head, ribs and legs as a result of being trapped in the lift as she descended to get her food from the vendor. When she punched the lift from the 10th floor, it crashed to the ground floor. She was brought to the emergency room, but the injuries prevented her from surviving.
Had the elevator been functional before the incident?
There had been complaints about the lift in the last four years and it has been having issues. People have been trapped inside it, and they (the hospital’s management) had to put on the generator to make them come out of the lift. I think it is the multiple maintenance failure which has been on for a long time that killed our colleague. It is important that as a country and as a government, our maintenance culture should improve. If the lift was not working, then the hospital should have put a notification informing people not to use the lift. Why were they managing the lift that was not working for years and murdering our doctor before thinking of revamping it?
For us, it is a very big deal, we cannot lose a medical doctor like that and sweep the matter under the carpet. It is no longer business as usual. The NMA has set up its independent inquiry panel to look at this matter and we must say that we want to appreciate our affiliate – the Medical Guild – in the state for working with the government and the Ministry of Health on the matter, and we are going to be having their details about the investigation, but the NMA has its inquiry panel that will look at the issue from the beginning to the end, and proffer solutions and recommendations that will help forestall this kind of preventable incident in the nearest future.
How long is the NMA panel of inquiry expected to sit?
It is one week.
From your press statement, there was no blood available to resuscitate her when she was rescued. Has this been the case before Tuesday when she died?
New revelations are coming in now that the blood bank had blood but the bureaucracy in getting the blood was the issue. Apparently, there was blood in the bank but there are a lot of bureaucratic processes in getting the blood from the bank, and because of the severe injuries she had, she could not make it. She was stuck in the lift for one hour and we did not get people to rescue her on time and the lift operators were nowhere to be found. So, the doctors had to use knives and irons to open the place. It was a severe crash.
We have said that there should be a revamp in that process (of getting blood) and there should be a revamp in the process involved in blood collection and transfusion, and they should make sure that the process is seamless and people should understand what is going on. The accessibility should be made easy because right now, the process is very ambiguous, and not smooth. I was at a programme some days ago and somebody called and said the same thing. So, it is not just about medical doctors, we want to make sure that this event (the doctor’s death) will revamp healthcare in Lagos.
What informed your decision to call for an indefinite strike at General Hospital, Odan, Lagos; Lagos Island Maternity Hospital, Lagos; and the Massey Street Children’s Hospital, Lagos, considering that resident doctors are on strike and other patients would need urgent attention?
We have apologised to Nigerians and Lagosians that we are very sorry and we are mourning our doctor. The three hospitals we directed to embark on an indefinite strike are the hospitals where our house officers do rotations. They do medicine and surgery posting at General Hospital, Odan; obstetrics and gynaecology posting at Lagos Island Maternity Hospital; and paediatrics posting at Massey Street Children’s Hospital. It is important for us, as NMA, doctors, and Nigerians to mourn our doctor that was just gruesomely murdered. So, because of that, we are stopping services in those hospitals but other government hospitals in Lagos are rendering emergency services for five days so that the world can see that it is about changing the narrative in the health sector because any of us could be in that situation; it could be our relatives, our mothers, brothers, and others. We apologise but this will help us get justice against those that have killed and murdered our doctors.
It is an indefinite strike until we get results and as soon as we get to the root of the investigation, we can name names and shame names and we can see that it is not just justice that is being heard but it is justice that is seen and everybody knows those that are responsible for the gruesome murder, then we will call off the strike. It is about getting a result and getting recommendations that are important for us. Every day, we evaluate the state of things as we go on. We will make very informed decisions as the days go by.
The Lagos State Governor, Babajide Sanwo-Olu, said the death was due to a mechanical failure. What is your position on this?
I do not know what mechanical failure means but what I know is that the lift has been malfunctioning for a long time, and this doctor died on the lift. There are mechanisms for the safety of lifts that we all know but that lift did not have a functional uninterruptible power supply system, and it did not have buttons or numbers to call when one is stuck. So, I do not understand what mechanical failure means but what I know is that our colleague had severe injuries due to the crash that happened in that lift in her workplace. If it was a mechanical injury, the experts will help us to look at it. We have set up a panel of inquiry that has members of the association, our friends from the Nigerian Bar Association, and our friends from the Nigerian Society of Engineers that will look at it critically and tell us the root causes and analysis of the accident and we can come out with our independent report and let everybody know what we found out. It is important that we do not trivialise issues like this; there must be compassion in our statement, there must be hope in our statement, and there must be love in our statement. We must feel empathy and know what the state and the doctors are going through at this moment.
Some Nigerians also criticised the governor’s wife, Dr Ibijoke Sanwo-Olu, for attributing the death of Dr Diaso to an “arrow fired into the health family.” What do you have to say about this?
I was not at the scene where the first lady said that. I did not hear what she said, so I cannot comment on what I did not hear. But I do not understand the import of saying it was an arrow because this accident was preventable, and I saw a tweet tagging the former Commissioner for Health, Prof Akin Abayomi, and the governor in 2020, that the lift was not working, and now it has taken the life of a vibrant young, highly-intelligent medical doctor. The NMA in Lagos and the Medical Guild went to see the father of the deceased and it was very heart-wrenching. Her father said clearly that her daughter had to be the guinea pig to fix just a lift. That statement drowned me. This is one of the causes of brain drain in Nigeria, doctors do not want to stay because they do not feel safe, and there are poor working conditions and poor welfare. So whoever is responsible for the death of our doctor must pay for it, we are seeking justice.
Have you met with the government on the modalities of the investigations in finding out what led to her death?
The Medical Guild is on the team of investigation with the Lagos State Ministry of Health. They are going to send the reports and recommendations to the state chapter of the NMA. The NMA in Lagos also has its independent panel to look at the issues that caused her death. We will bring out the resolution and recommendations and let the public know what caused her death and who was responsible for the death of this amazing doctor.
So, what are the minimum demands the government must meet before the strike will be called off?
We must see that due diligence to prevent a recurrence is done. We must see those who are responsible for her death; they must be prosecuted. We must see their faces, and know their names and those that must go to jail should go to jail, and there must be a system in place to ensure that all the doctors living in the quarters are safe. There must be an instant change in the lift system of that particular building. If the building has 100 medical doctors living in it, there must be proper management of that place; there must be water and steady light. We also demand a letter of condolence to the body of doctors in Lagos because we are mourning. We demand a condolence letter that we can at least share with the parents of the deceased. These are our minimum demands.
What are the other major challenges affecting medical officers in Lagos hospitals?
Lagos state is trying among the states in Nigeria, but we can do more and do better. Medical house officers have not been paid their hazard allowance which was approved by the Federal Government about two years ago. So, all these welfare packages, the right working conditions, right working tools must be in place. Everybody must live up to their responsibility. Let us stop passing the buck. The things that need to be done must be done. The working conditions are not satisfactory, and doctors are complaining. When a doctor leaves the system, there should be a direct replacement immediately so that doctors are not overworked. Many doctors have been dropping dead in the last few months and in the last few years because of stress and overwork and we are not replacing those leaving on time. For us in the NMA, we are to protect our members and see that there is a direct improvement and proper auditing; someone must be in charge so that the public will know and all of us will know the processes in place, moving forward.
Healthcare is not just for doctors, it is for Lagosians. When healthcare is well-handled and the right tools, the right working conditions are there, and doctors are protected, nobody will leave the country. There has to be a purpose-driven welfare scheme for doctors. Give doctors mortgage loans, and car loans and give private hospitals support loans to support the economic hardship we are going through now. There is an increase in the price of fuel, and the cost of living has increased but salaries have not been increased and there is no commensurate value of what we are earning. The government needs to sit down and revamp the healthcare space so that we can be the centre of excellence in Nigeria.
Are there specific issues you have raised with the state govt which they have not addressed before now?
Yes, there are and the Medical Guild is on top of that, and they have given the state government some deadlines and we hope in the next few weeks, we can see the results and see that there is an improvement in the welfare package for doctors in Lagos.
What do you recommend that the government can do to reduce the incessant strike of the Nigerian Association of Resident Doctors?
The NMA is not on strike but NARD is on strike and it is one of the largest affiliates of the NMA. What they have been demanding is the same thing they have been asking for since, and it borders on the welfare of doctors – right working conditions, direct replacement of doctors that leave the system, mentorship, and proper love. The Medical Residency Training Fund must be available on time, and the system should be changed to give optimum healthcare to Nigerians. So, I support their demands, and as NMA in Lagos state. What they are demanding will revamp the healthcare system across the board. The government should listen to them so that the incessant strike can stop.
Will you demand compensation for the deceased doctor’s family and what amount will you suggest?
We do not have the answer yet. Let them give us a recommendation and we will take it from there.
